June 1, 2020

Nutrition Supplements for Health: Help or Hype?

How do you know if supplements may be a beneficial addition to your daily nutrition? With a multitude of products promising to be the missing link in your nutrition regimen, sports nutritionist Dr. Krista Austin cuts through the noise and gives you the facts. Listen in as she shares how you can determine deficiencies in your diet and what considerations should be taken before adding supplements. Drill down on the benefits and best sources for vitamins, minerals, anti-oxidants, probiotics, and omega 3’s.

TriDot Podcast .036:  Nutrition Supplements for Health: Help or Hype? Intro: This is the TriDot podcast. TriDot uses your training data and genetic profile, combined with predictive analytics and artificial intelligence to optimize your training. Giving you better results in less time, with fewer injuries. Our podcast is here to educate, inspire, and entertain. We'll talk all things triathlon with expert coaches and special guests. Join the conversation, and let's improve together. Andrew:  Welcome to the TriDot podcast, have you ever gone to the vitamin and supplement aisle of your local grocery store, or peruse a nutrition product website and just felt overwhelmed by the multitude of products promising to be the missing link in your nutrition regimen. Today, we hope that help out with that as we dive deep into what each of these supplements do for your body, and whether or not you need to take them. Our key guide to the nutrition product market is our resident nutritional expert Dr. Krista Austin. Krista is an exercise physiologist and nutritionist, who consulted with the U.S. Olympic Committee in the English Institute of Sport. She has a PhD in exercise physiology, and sports nutrition, a master's degree in exercise physiology and is a certified strength and conditioning specialist. Krista, welcome back to the podcast. Dr. Austin: Well, thanks for having me again. I'm glad to join up with you two and see if we can’t help listeners out with a really important topic. Andrew: Yes. Dr. Austin: So thanks again for having me. Andrew: Of course. Also joining us is pro triathlete and Coach Elizabeth James. Elizabeth came to the sport from a soccer background and quickly rose through the triathlon ranks using TriDot. From a beginner to top age grouper, to professional triathlete. She's a Kona and Boston Marathon qualifier, who has coached triathletes with TriDot since 2014. Elizabeth thanks for coming on. Elizabeth:  Absolutely, my pleasure. I am so excited for another great episode. Andrew: And who am I? I am your host Andrew the average triathlete, voice of the people and the captain of the middle of the pack. Today we'll get going with our warm-up, before moving on to our nutritionally helpful main set. Then we'll cool down with a nutritional question from one of our own triathletes in the TriDot family. It's going to be a great show, let's get to it. Narrator:  Time to warm up; let's get moving. Andrew:  All right. For today's warm-up question, I'm going to borrow a word from Krista's tennis background and apply it to triathlon if there were such a thing as doubles triathlon, just like they have doubles in tennis. Where you do the whole swim, bike and run tethered to someone else, and let's even say for the bike leg, you'd be rocking a tandem bike with your triathlon doubles partner, who are you racing with. Dr. Austin, who would you pick? Dr. Austin: Well, I would actually probably do this with one of the Special Forces operators that I've worked with. Just because if you're going to do something like this, you need a lot of laughs. And to just kind of choose someone who is going to suffer through it with you, they know what suffering is, and they're going to make it pretty funny. So I think I would choose one of them to bring with me. Andrew: Oh, very good. I think it's a great pick. Elizabeth James, who would you do your doubles triathlon with? Elizabeth:  So I would absolutely love to do this with my husband. I'm not sure if I could actually convince him to do that, but I think that would be great. I love the experiences that we can share together, and I think that this would make for some great laughs and some good memories too. Andrew: Yes, it absolutely would. And I think this is a great time to mention what you and Charles do every Valentine's Day together. Most couples go on a Valentine's Day date, maybe catch a movie, maybe go to dinner, tell everybody what you and Charles do every February 14th. Elizabeth:  So our idea of the Valentine's Day date is to do a run. When we were living in Nebraska, there was a Cupid's couple 5k or 10k where you actually would run tethered together. And then they would take your kind of time and compare that to the other couples, and that was something fun. We haven't found a race here in Texas where you actually are tethered together, but we still try to find a local event and make that as part of our Valentine's Day date. Andrew: Yes. So when I asked this question, you've in a way already done this with Charles. Elizabeth:  At least a portion of it, yes. Andrew: Yes, and would be excited to do the rest with him. Elizabeth: Yes, exactly. Andrew: That's a great choice. For me, I kind of mentally for a second played with the idea of how cool would it be to do this with a pro. Just picking a pro, and knowing that you can do a whole race alongside of them. But the more I thought about it, the more I decided that I would not want to be the weak link holding somebody that fast back from performing how they're able to perform. So I started thinking about friends that I trained with, people that I know. And when I came down to it a buddy of mine, I think I mentioned him on the podcast before. A buddy of mine from Sarasota Florida is now dabbling in triathlon, and he's done a couple of local races there on the Florida Gulf Coast. He's training for his first half ironman event, and just a friend of mine that I go way back to middle school, high school with, one of my best friends from Florida named Jonathan. I think it'd be really fun the race with him. He has been training with TriDot for a few months now, and already has a higher bike dot than I do. And so he would be probably a little faster than me there, but I'm going to be stronger than him in the swim and the run. And so I wouldn't feel like I'm holding him back the whole time. Just to be on course with a good buddy doing a sport that we both now really enjoy would be a whole lot of fun for me. So shout out to my friend Jonathan from Sarasota, doubles triathlon. Let's get it going, new way to do the sport, right? Elizabeth:  Can we also just give a shout out to all of our visually impaired athletes that are already doing this, that are completing an entire triathlon with their guide. I mean gosh, both the athletes and the guides are fantastic. And when you were initially talking about this question, I immediately thought of some of my good friends that I've also had the opportunity to coach. Andrew and Dave, they are multiple I mean Ironman finishers, and again they do the whole thing tethered together, and it's just fantastic to see. Andrew: No, that's awesome. Yes, I know Bob Babbitt, kind of celebrity in the triathlon world. He has the Challenge Athletes Foundation that puts on a lot of races that allows folks with all sorts of disabilities to compete, and thank you so much for that shout out because yes whether it's just a marathon or a local 5k, where you see a pilot guiding a visually impaired athlete, just a super cool way for athletes to compete. So great shout out there. Narrator: On to the main set. Going in three, two, one. Andrew: Our main set today is brought to you by our friends at Garmin. In the fitness and multi-sport market, Garmin products are the gold standard, known for their compelling design, superior quality and best value. As a triathlete, Garmin can be and should be your very best friend. They offer best-in-class GPS watches that can track your every swim, bike and run with ease. When you are out on the bike, Garmin's Vector power pedals can measure those all-important watts. While their edge cycling computers conveniently display all your data in real-time as you ride. You can also bring Garmin into your pain cave with their tax indoor trainers and accessories. I tell everyone who will listen that my tax flux indoor smart trainer is the best investment I have made in my own triathlon training. The best part is Garmin is fully integrated with TriDot. So your Garmin Connect and Garmin health data seamlessly stream to TriDot, and your training is continually optimized. So head to garmin.com and check out all the cool tech they have to offer. So Krista when we use the term supplement, what type of product are we referring to? Is it just anything that we take outside of our regularly scheduled meals? Or are they products that do something more specific than that? Dr. Austin: So if we take a look at the pure definition of a dietary supplement, essentially it’s defined as a product that's going to provide us with a vitamin, Herbal, botanical or mineral that supports the biological function. And so when we turn over the label that in essence is what you're going to try and look at. Now there are some things that we'll delve into as we go through these podcasts that we'll have to clarify that sometimes the way we supplement in sport is through something that is considered a food like sodium bicarbonate, which is essentially Arm and Hammer baking soda. So we will go through the health and the performance ends of this, and talk about at what point are we using something that is truly a dietary supplement. Andrew: Some people love taking, I mean just anything promising them better health, while other people are a little bit more suspicious of what companies are encouraging them to put in their bodies. How do health and nutrition experts go about determining what supplements are safe and good for us to take, and what we should avoid? Dr. Austin: So the first thing that we always tend to look at is first and foremost, what is the label on the back of the product that you are handing over to us? If you take a look, there are three different fact labels on various products. There could be a Nutrition Facts label that some people say this is a supplement, and really it's a food-based supplement. There may be a supplement Facts label, and that's when it truly is a dietary supplement, that's how they got it into the market, and that's how the FDA the Food and Drug Administration will look at it. And then there are drug facts which essentially is actually a medication. You might see that as an over-the-counter like Vibrant, which carries a drug Facts label, but that is caffeine, okay. Regulations around each of these different types of labels differ pretty significantly. So the reason we take a look at what the label is because it's going to tell us a lot about where it was probably manufactured in terms of the type of facility. And then once you take a look at the fact that it's actually a dietary supplement, we're also going to say okay, what other labels does this product have on it? Does it have a label such as NSF? (Which stands for the National Sanitation Foundation.) But also is a laboratory that goes in and certifies to say hey, they are producing this underneath certain regulations. NSF also offers batch testing to ensure that there are no contaminants, including banned substances that may be on the World Anti-Doping Agency's (WADA) list of banned substances. We'll also see if they have a label for USP, which stands for the United States pharmacopoeia. And it evaluates products against science, based on quality standards. Another label we'll look for is one that says GMP; it indicates that a certified facility that ensures the supplement’s quality and purity and the strength and composition is produced under good manufacturing processes. That's what the initials stand for, and that has been established by the American national standard. When you start delving into some products, you'll also see that it talks about them being organic. So the USDA has a certification for manufacturing facilities to ensure that they have proper conduct when they're including the use of various organic products and to ensure that they preclude the use of anything that is like a synthetic fertilizer. And then there's the Quality Assurance international for verification that it's being produced by the National Organic Program guidelines for organic ingredients. So there are a lot of things that we're going to take a step back and look at, and we'll also look for other companies such as the banned substances control group. They have a certification for batch testing to ensure that your product does not include any substances that are banned by the world anti-doping agency. And same with a company called Informed Sport, and the good thing about NSF, BSCG and Informed Sport is that they actually have databases that athletes can go to look for supplements that have been batch tested, to ensure that there are not substances banned by the World Anti-Doping Agency. So those are the first things that we're going to sit back and take a look at. Andrew: So if an athlete is in a GNC or a target or a Walmart or shopping online and they're looking at a specific product and thinking about whether it's a vitamin or a mineral, and they're thinking about trying something. Do we need to see all of those acronyms on the label to know that it's safe? Or are there other certain things that we should look out for? Dr. Austin: Well, the first thing I'm going to tell people to do is to actually go online and look at the product these days before they ever walk into one of those stores. And GNC, you probably will find certain products that have been batch tested and carry these labels; the question is to what extent do they carry them? And that's where they may, in fact, differ a good bit. Like I believe like a product like the Vitargo, which is a carbohydrate, I believe they carry that in GNC and Vitamin Shop A, and it has been batch tested by the banned substances control group, okay? And it has all these certifications for GMP, things like that if you take a look at the back of the product. So you will see something like that at those dietary supplement stores. However, it doesn't mean that you're going to find those certifications in every product that's in there. So a lot of it is about doing your homework upfront and going to the company's website, to understand what do they do to help ensure the quality control in essence of the product you're getting ready to go buy. I want to just pick one up off the shelf because that's when you're more than likely to purchase one that maybe hasn't been controlled underneath the best circumstances. Elizabeth: I'm really glad that you brought up compliance with anti-doping regulations, and kind of what athletes should be looking for. Would you say that using those databases and looking at products ahead of time is the best way to make sure that athletes are in compliance with those regulations? Dr. Austin: Yes, absolutely. I mean if you go in between those three databases that I talked to you about NSF, banned substance control group and just Informed Sport, you can find just about any supplement that an athlete is going to need. Every once in a while, we will come across one that is not in those databases. And then I turn around to the athlete and say okay, why are we needing to take this? And if it is really important, I go back to companies who do batch testing with those groups and say okay, let's get it from there. I mean I had that happen with an athlete the other day, where because of gastrointestinal issues he has stopped competing because they're just that severe. And he's working with what's called a naturopathic medical doctor. And they were looking at different strains of probiotics, and we said okay, one strain that's been batch tested by thorn, which is the company that we were looking at was not helping to resolve the issues. But when he took the online quiz about what probiotic do I need, it actually pulled up one that did not have the NSF label. And so I said do you what? Its Thorne, it's a very reputable company; they do a very nice job. This is one that we're probably then going to go with so that he could test out the other probiotic strain. So you always want to do your best to try and make sure that you're not going to have any contaminants. But when it comes down to it, you're not always going to find every dietary supplement that may be utilized by the athlete in those databases. So we just have to be cognizant of that and say why we're using this, and is there a legitimate reason to be taking it and trying to resolve something. Elizabeth: Yes. I love how you talked about using a supplement for this particular athlete to kind of alleviate some of the GI distress that they were having. When you're working with an athlete on their day to day nutrition, at what point would you recommend the use of a supplement? Dr. Austin: You know, typically I don't help them dive into supplements until we have made sure their nutrition is just very robust. And the other thing I like to challenge athletes to do once they get past the health supplements is to say okay, we can monitor training load and the rate at which you adapt to training before you jump into this performance-enhancing supplement, this ergogenic aid, whether it's just even like beta-alanine or a nitric-oxide product. I want us to know through specific test sets, through your training load and everything else that you do, key metrics that are going to tell us whether or not you're actually benefiting from this supplement. Because oftentimes I think people say where's that blue pill that I can take and get that extra edge. And really it's not there, for most athletes they've got to do a lot of work and the question is are you really getting a benefit out of what you're taking. And I don't know that it's as robust as athletes may think. Elizabeth: I mean I've always appreciated our conversations just about day-to-day nutrition, performance nutrition, and I think that what you've just outlined there also goes back to that. That before we even look at supplementing, we need to make sure that base of just the everyday nutrition has been really addressed first. And I think that's a great thing for athletes to just kind of come back to and remember is we got to nail those basics first, and then look at where a supplement may or may not be appropriate. Dr. Austin: And they need to realize too that oftentimes supplements that are produced underneath the quality control standards that we talked about, the ones they'll benefit the most from are ones that they have to actually take a little bit more long term to get the effects. And that without actual training, you're not going to get much out of it. There's very little that acutely is going to help you. I think on race day things like caffeine and carbohydrates help us far more acutely than anything else. And so I think they've got to be cognizant of that. To my knowledge, I've never really seen a dietary supplement just if it's legal and it's an ergogenic aid it doesn't just help you right off the bat; it means training on it, and they've done research with even like sodium bicarbonate and beta-alanine to show you know what, if you train on it you're going to get a bit more gains, just because you're able to do higher-quality work than you are if you don't train on it. So it really highlights that even if you're picking up that Arm and Hammer baking soda to help enhance performance, that at the end of the day you probably need to train on it. Andrew: I will go ahead and tease for folks. On today's podcast, we're about to dive into a lot of different supplements that people can take just for their day-to-day general health. Two weeks from now, we're going to be releasing a whole ‘nother episode with Dr. Austin talking about all the different supplements we can take that are on the market that are advertised as helping us on race day, helping us in our training including the sodium bicarbonate that she just mentioned. So be on the lookout for that episode dropping soon where we dive into a little bit more of that. So Dr. Austin knowing that we had some supplement conversations coming up, I pulled our athletes on the I am TriDot Facebook group to find out exactly what supplements specifically our athletes wanted to learn about. And so let's just kind of go through here, and start off with some of the vitamins and minerals that folks were asking about. Now, this is a little bit hyperbole, but it seems like there is a vitamin for every letter of the alphabet, right? There's your vitamin A, your vitamin B, your vitamin D. Dr. Austin what are kind of the major vitamins and minerals out there on the market, and what do they do for our bodies? Dr. Austin: Yes. So when I take a look at the vitamins the minerals, I start off and say okay is it a vitamin that is fat-soluble or is it water-soluble? That's where I start off. Fat-soluble vitamins are ones like vitamin A, vitamin D and vitamin E and K okay. And those are ones that if we take them in doses that are too high, they start to become stored by the body and can potentially do some harm. Conversely, you have water-soluble vitamins like the B vitamins. That if you take a little too much of it, you actually are going to end up just losing it in the urine. You might saturate your stores, but the potential to have severe side effects is more minimal. Now there are some of them like niacin that if you take them in large doses actually produce side effects. But overall, if you take a look at the a-to-z composition you have water and fat-soluble vitamins. Then you dive into the actual minerals themselves, and that is ones like iron we all probably have heard about that because we're talking endurance athletes. Zinc, copper, so you really have a whole plethora when you talk vitamins and minerals of cofactors that are needed for metabolism, right? And that's what they're there to do for us on a day to day basis. Elizabeth: Now of all of those vitamins and minerals, are there ones that athletes are typically deficient in? Or does that kind of just very person-to-person? Dr. Austin: It really varies from person to person. I will just tell you that I have some athletes that are such good eaters; we will never even go near a multivitamin and mineral. Just because they meet the recommended daily allowance for the vitamins and minerals in their day to day nutrition or averaged across the week they're meeting it, and so we never touch it. Conversely, we have others that sit down they go gosh, I'm just missing a few key aspects, and it might be things like vitamin D or vitamin K that they sit back, and I say well, how much are we actually missing? And is it robust enough to actually warrant a dietary supplement? And then in some instances, you do a dietary analysis and what you find is that an athlete is getting the recommended amount, so irons is a real common one. And you look at it, and you say yes, but is that enough for an athlete. Because those RTA's are typically based on the everyday person who's not training. And so underneath those circumstances, we actually turn around and take a look at biochemical testing to understand whether or not they may benefit from taking a supplement like iron to help ensure they don't deplete their stores, and really compromise their training. So when I sit down with someone, we have a pretty good reason for why we do what we do, and we only supplement once it's really necessary. Elizabeth: Another thing that I know has come up quite frequently, and has been a question that was asked on our I am TriDot Facebook group. I mean, we see men's vitamins, women's vitamins. Biologically, do men and women have differing vitamin and mineral needs that we should be aware of? Dr. Austin: Biologically, I will tell you that men are usually a little bit larger than women. And so there is an increased recommendation, or in the instance of females we know like with iron that they have a menstrual cycle every month usually. And so the recommended daily allowance for a female is higher than it is for a male. But overall, if you take a look at it, the upper and lower limits are usually not that different between males and females once they have reached maturation, once they're adults. They're pretty similar and even coming up the pipeline. But the reason they tend to put these mega-doses in is because, from a marketing standpoint of view, they do want you to believe that you may need them for a specific reason. And at the end of the day, there really isn't a good cause for that. And oftentimes when an athlete shows up, even with their batch tested supplement and it's got these really large doses of even water-soluble vitamins, it doesn't matter to me whether they are male or female. 'll say hey look, let's maybe save you some money and let's cut the serving in half because it'll say take two capsules daily and I'll say well let's just take one because if we go through the label, it shows us that you're getting more than enough water-soluble even with one capsule. And at least 50% of the RDA in the actual fat-soluble ones. And I said if that's the case, and sometimes it's up to a hundred percent even. I said, let's sit back and see how we can improve your nutrition before we actually go down this road. And typically males and females don't have immense differences that they need to pay attention to; it's just if you take a look at something like iron, females do tend to require more in order to support biological function than males. Andrew: What I love about your approach to supplements and to vitamins and minerals is kind of how you outlined okay, let's start by examining the diet and see what you're getting and the food that you're eating. Well, let's try to fix it there and then we'll talk about maybe supplementing some things. Because A, I think it's probably a good thing for us all to take a closer look at our diet anyway. And so this just gives us another reason to do that, right? And then B, I mean I think so often as an average everyday athlete, you have friends talking about taking this vitamin they just discover, or you have people buying this and that. And you almost get this feeling that you're not as healthy as they are, you're not doing your nutrition as right as they are, because they're taking all these extra things that you aren't. And so you kind of give you that FOMO that you're missing out on potential vitamins and minerals when you might not be if you're getting your diet right. So I love that the approach, and with that one of our athletes specifically mentioned iron and said as a vegan, I'm wondering if I need to supplement more iron in my diet because my diet is vegan, I don't need as much meat. So are there any other diets that are kind of popular and common like maybe a vegan eating more iron that are noteworthy, that people are oh, if you're this or that you should consider maybe this vitamin or that vitamin that you would mention? Dr. Austin: You know it really comes down with any dietary or nutritional approach to how well do you do it. I've worked with vegans over the years, especially leading up through like the 2016 games and beyond. It's kind of become a more popular approach with athletes, and what I found is when they do a good job with their nutritional intake, they're getting plenty of iron. And if we check their stores, and they have plenty of storage, it's because they're eating such high-quality foods usually, and being so conscious of what they're taking in and how much, that I think overall they sometimes do a better job than even the person that is a non-vegan. Similarly, if you turn around to someone who's paleo or keto, it really comes down to what are they choosing to take in to create that nutritional plan. If they're turning around and saying well, I can do this off of inappropriate I guess you could say fat and protein sources or carbohydrate sources, then yes, they're going to have a very micro nutrient-poor diet. Even the person who's taking in the average dietary recommendations, right? With no real special oomph to it. They can have a poor micronutrient plan, just because they're not choosing high-quality foods. So really it comes down to analyzing it, looking at the quality of it, and that's why I love an app like chronometer because I do go in there and work with each athlete to say okay, look at what it's giving you in terms of information. When you hover over each micronutrient or the macronutrients, it shows you the foods that you're driving that from, and it shows you if you're deficient in it. And so I try to do a lot of education with the athletes to say hey, let's take a look overall and go from there. And typically, once they review the foods that are underneath that macro and micronutrient, they can turn around and look at me and go. Oh, I think I know where I'm going wrong or hey, here's where I'm going really right. So I think it's all dependent on the individual, and how well they put together their nutritional plan. Elizabeth: That's one of the things that I was going to mention as well. Is that the apps are just a fantastic way of really looking at what vitamins and minerals are in different foods, and looking at those micronutrients and then identifying where are we getting them from, where we might be deficient. And then some changes that we can make just in our day to day nutrition to kind of hit those recommendations as well. Andrew: Yes. Elizabeth you and I, I think for the first time I heard about chronometer from Dr. Austin on our very first podcast recording with her. Have you been using it since then? Elizabeth: I actually have been, yes. I switched from what I was using before, and am now just a big fan of that app. Andrew: Very good. I downloaded it, I have not started using it yet, but I have downloaded it with good intentions. Elizabeth:   Hey, it's a start. Dr. Austin: So Elizabeth, have you moved to the point where you're using the timing function on the chronometer app? Elizabeth: I have dived into it just a little bit, but that's kind of the next adventure, and I’m excited to work with that a little bit more. I might have to pick your brain a little bit more outside of the podcasts on that feature too. Dr. Austin: Yes, I think it definitely warrants something. Because that's been one of the biggest assets that I think I've been able to show people. I mean they're kind of a newer app, but I'll just tell you use that app to its fullest capabilities; you might not have to do too much supplementation, to be honest. Andrew: Good to know. Note that everybody, that's an important moment in today's episode. Dr. Austin, let's talk about heart health for a little bit. Heart health is something that is really mentioned pretty often in conjunction with wellness products, and I think the big one that folks hear about are omega-3 supplements, essential fatty acids. Who should be looking at taking these? Dr. Austin: So the people that, and here I go again with that nutrient analysis, right? The individuals that we turn around and look at omega-3 supplementation with are those that have deficiencies in their diet, right? And there are a lot of people who will just turn around and say Krista I don't like fish, and I don't like this or that. And their diet is very low in omega-3s, it's very high in omega-6, and so the ratio is off. And so those are the individuals that I look to supplement first and foremost. Secondly are those that have high cholesterol, so one of the biggest reasons that we may take omega threes is because of its potential effects on what is called your ''bad cholesterol'', these are your low-density lipoproteins. And in some instances, we can actually see a reduction in LDL when we do supplement with Omega threes. So it's one of the biggest reasons that people may take it to improve their heart health. And then there are those that just from an overall blood flow standpoint of view, one of the reasons they will take it is just because they get an improvement in blood flow. And they say well, aren't we preventing heart disease with this and I'm like well, possibly. Through the use of it, if it's taken appropriately, you may actually help your heart health by reducing bad cholesterol and improving blood flow. So that's one of the reasons that people will turn around and use fish oils or what we call omega threes, and really focusing on the right ratios there to help them get through everything. Andrew: Something I've seen advertised as a benefit to certain foods or certain products is the presence of antioxidants. So doing my own research for this episode, I'm not the expert, but I don't want to sound like an idiot when I talk about these things. I have a vague idea of what an antioxidant is, but to learn a little bit more, I googled it, and I found this definition: “Antioxidants are compounds produced in your body and found in foods. They help defend yourselves from damage caused by potentially harmful molecules known as free radicals.” Now, this was both helpful and not helpful, it makes antioxidant sound important, but I'm still unclear on exactly what they do for my body, and if I need to supplement them into my diet. Dr. Austin, help me out here. Dr. Austin: Yes. So a lot of people look at antioxidants as vitamins, such as vitamin C. And we do know that vitamin C in adequate doses, and know that I use the word adequate can help us fight off the free radicals and reduce oxidative stress. When it's adequate, we tend to get a good balance and what is we see occurring in the athlete's body. But when it's in excess, it may impair the oxidative stress to a point that you don't want it to because oxidative stress and free radicals are actually kind of good for us as athletes. One of the things that we've questioned for years is do we need them to maximize training adaptations, and I would say yes, based on the current research literature we don't want to send all of that into hibernation. We actually want to let it go ahead and do its job, which is to inform cells that they need to adapt. And so that's why when you're taking doses of even water-soluble vitamins like vitamin C, another one that's popular is like vitamin E. I say hey, hold back and be careful because you don't want to limit adaptation. I know glutathione was another antioxidant that one of your listeners asked about, and I co-added it with the same concept. Is we don't want to working with an athlete who's trying to maximize training adaptations impair the adaptive response. And so sometimes it's good for us to actually create a level of inflammation in the body. There's a good level of inflammation, and then there are bad levels of inflammation, right? And I think you'll best control that by how you dose out the exercise itself. So we have to look at it from the dose-response, and whether or not we're trying to create a train adaptation and making sure that we don't ever over train the body. If we're overtraining the body, then we're going to actually cause so much harm anyway. That no matter how much you take as an antioxidant, you're not going to stop kind of the repercussions on the back end. Andrew:  It can be used as a form of correcting, doing too much work on your muscles? Dr. Austin: No, it should not be viewed as that at all. It should be viewed as something that you need adequate levels of in the body, and that with adequate levels; we can take care of our day-to-day cell operations, muscle cell operations. But otherwise, really if you take too much, you may just impair the entire adaptation process. So a lot of those studies are hard to do, you know that we rely on animal models to do them. And so the translation into humans is oftentimes a little bit disjointed, just because we don't truly know long term what constitutes adaptation or a lack of adaptation in a human being. But I think overall; you should be able to get most of what you need in your diet. Elizabeth: Now, along with antioxidants, something that continues to make its way more and more into grocery store products are probiotics. I mean goodness, I've seen them now worked in to drinks and granola bars, they can be taken as a vitamin, kind of just as a pill. Kind of give us the rundown on probiotics and when or when those might not be helpful for athletes? Dr. Austin: So probiotics are essentially responsible or prominent we should say for restoring your gut flora, okay. And oftentimes if you talk to most athletes, they will tell you look I've got X, Y & Z going on with my gut and that can be for a variety of different reasons. Oftentimes, I find that before we ever go to a probiotic, that we actually want to stop and say wait a minute, what are we doing with our overall basics. The hydration side, fiber intake, do we have enough soluble and insoluble fiber. Do we have enough magnesium in our diet, okay? Basics that we need to ensure that our gut functions properly. The other aspect of that is training can cause a good number of hormonal, I guess negative consequences or negative impacts on our hormones. And oftentimes that's because there's an imbalance between energy intake and the rate at which we're outputting that energy. And so I always go back to that first and foremost to say, before we go down the probiotic road, what is it that we actually need to be doing the right way. So that we don't get a supplement confused with something that's related to nutrition and training load. When we do go down the probiotic road, it's typically because we have unresolved gastrointestinal issues that just are bothersome. Okay, it may be stomach bloating, it could be gas. It could be constipation, and people say this is something that is really bothersome, it's impairing me and my ability to train or just live a healthy lifestyle overall. Like it's that bothersome, and that's when we do turn around and say okay, maybe the gut flora is diminished. Maybe we need to go down that road. And these days we're taught that a prebiotic is necessary to help fuel the actual activity of a probiotic, and so the story keeps getting a little bit more complicated, right? They'll say you need a pre and probiotic, and in fact, there are different strains of probiotics that you can try. And it's something that really is still in its infancy, and so to be putting it in foods is pretty interesting to me, because the dose effects and the true science behind all of it is not well developed yet. So I'd always just be careful. I mean if they're marketing a food product because of the probiotics in it, I would kind of question how much you're actually going to get out of that. And that if you need probiotics, let's put it in a batch tested dietary supplement and truly understand its effects. Andrew: No, I think that's great advice. There was one moment probably a year or so ago where I was considering trying some probiotic supplements. Whenever I would just go for an evening run, I was having a hard time with that feeling of having to go to the bathroom, fighting a little gas along the way. And right before I tried pulling the trigger on purchasing a probiotic supplement, I was like well; let me see what I'm eating at lunchtime and kind of play with that and see if it has an effect. And what I realized over just kind of some trial and error was at lunchtime, if I had an apple, I'm a big fruit guy, I love fruit. If I had an apple with my lunch, and then went for an evening run a hundred percent of the time, I had what I now refer to as the apple toots. And I would struggle with doing that run as prescribed, and if I don't have an apple at lunch, I've yet to encounter any other food at lunchtime that induces those same toots. So I now save apples for dinner time or days where I don't have a run. And it seems for me have solved that problem without going to a probiotic. Elizabeth: The apple toot story. Dr. Austin: A lot of people have that story just so you know, we find that a lot. Andrew: With apples? Dr. Austin: Well, it's not apples per se, but it may just be another item that is causing the issue during exercise. so typically if we time things correctly and make sure they don't have it prior to exercise, we can get a lot resolved, a whole lot. Elizabeth: So we've talked quite a bit about things to take during the day. Let's shift focus just for a moment and talk about sleep and supplements for sleep. As athletes, we know that sleep is critical for both athletic performance and just day-to-day health. And to get a good night's sleep, I know that some folks turn to over-the-counter sleeping pills or melatonin. Is this a viable way to ensure a good night's rest? Dr. Austin: You know there's no supplement out there that we can guarantee anyone that it's going to be the reason that you get a good night's sleep. But what we do know is that a dietary supplement like melatonin may actually improve sleep, because the person may have just the need to get into more deeper REM sleep, or what have you. Some biochemical aspects that the melatonin has been shown to help them get to sleep and stay asleep a good bit better. The only thing about that is that when they wake up in the morning, they may describe a little bit of grogginess. And the reason they feel groggy or what-have-you is because there's a hormone called prolactin, and prolactin typically increases a good bit more when we take melatonin before sleep. The other approach to that is that sometimes there are products out there that will put small amounts of melatonin into their products. However, oftentimes they're not batch tested, but people have told me you know what it actually works a whole lot better. I can sleep now because I'm taking this specific product. So it's a catch-22 because the research out there is not robust enough on all of these supplements that are promoted for sleep. And so I think we just have to be careful in evaluating it. Most triathletes today have a Garmin at least or something of that nature, a polar heart rate monitor. And they can sleep with that on, and actually look at the level of activity that occurs during their sleep. I don't really dive into the different sleep stages, but I say let's just take a week before you try taking this and see what your sleep looks like, just on your watch. They now also have the rings that do the heart rate variability, and the activity levels. So those are really becoming popular. And I just say let's just get a good baseline, and let's compare that to your perception of your sleep. Maybe you're sleeping better than you know, and we maybe need to review this a little bit. Then let them add the dietary supplement in, and see if that really changes. It gives us a bit more objective quantification, rather than just purely the subject of perspective of here how well I slept or did not sleep. Andrew: So, Dr. Austin, there's a good amount of products on the market that promised to help us out with our joint health. And I know a lot of folks with achy knees, achy elbows, achy shoulders might be tempted to kind of dive into that part of the supplement world. Are those products actually beneficial for our joints? Dr. Austin: So there are some studies that show us that taking products containing glucosamine and chondroitin, and some of those contain glucosamine, chondroitin and what's called methyl sulfonyl methane or MSM that's quite a mouthful right there. And they do show that it gives us some relief for some mild to moderate like osteoarthritis and that it is intended overall to help us maintain the health of your cartilage, okay. Your cartilage is kind of that rubbery tissue that helps to cushion the space between your bones and your joints. And so what I always do is turn around and take the same process, and say okay look, if we're doing everything well from a dietary perspective, we might even have been through elimination diets. Do we need this to help your joints feel better? Because sometimes we've actually found that just food allergies in and of themselves that they never knew they had until they started doing high levels of training. Might actually impact the way their joints feel. So something like that is out there, and I think once everything else has been examined, you can definitely take a look at it because it appears to provide some relief for mild to moderate like osteoarthritis. Elizabeth: Now I don't want us to dive in too deep on this, because I feel like this could be a whole podcast episode in itself. And I know that we'll probably dive into this a little bit more. But Dr. Austin, could you give us just surface-level your thoughts on CBD? Dr. Austin: So CBD is Cannabidiol, and there is a variety of different derivatives that come from Cannabidiol. But what we want to be clear with athletes on is that if you're taking a look at any of these products, you want to make sure that they do not have THC in them. That's the active component in marijuana that is banned by the world anti-doping association when they are in competition, okay. Out of competition, it is not, but athletes need to be cognizant that in competition it is banned. And that in fact, it takes a while to get out of your system. So if you're using it on a regular basis, you do need to be cognizant of what it takes for your body to eliminate that before ever stepping into competition. But the Cannabidiol products that are out there are attempting to help with what's called your CBD receptors, and there's a variety of them. The CBD receptors are thought to be part of the missing link, and a lot of the issues that athletes report with regards to gut health, endocrine health so your hormonal health. And the question is it going to help at all, especially with regards to pain? There's enough research so far that there is a tee wee process for medical marijuana, which would actually contain the THC to show that it can help with certain types of pain? But you do have to go through the tee wee process. So it's an interesting area, but I would say that it's an area that really does need to be explored a lot further before we understand the benefits to athletes. And to my knowledge, the banned substances control group is the one company that batch-test dietary supplements and shows you which ones do not contain the THC. So if you're looking for them, that's one place to go to help ensure a good clean product. Andrew:     Yes. If you're out there and you're interested in a variety of the CBD products, go there because you're going to want to make sure that you're taking the right thing and something that is batch tested and improved and safe. And we will Elizabeth definitely for sure do a longer podcast on CBD products. I know that's becoming a hot topic on the endurance sports market. Actually, there's a conference that the TriDot staff went to in Tempe, Arizona a few months ago, and there was a whole session for triathlon coaches on some of the products out there and what they're finding as athletes are beginning to use them. So we will talk about that more another day, but Dr. Austin thanks so much for pointing us in the right direction for folks are interested in those products. So listen, we've talked about a lot of different products today, a lot of different things that are out there. And let's kind of maybe end with this, if an athlete is starting to take something or starting to work a dietary supplement into their nutrition regimen. How do you know whether a supplement is truly providing benefit, or if it's just some sort of placebo effect? Dr. Austin: I always take a look at it from what is their long-term commitment to its actual use. And oftentimes if they forget to take it, it's a clear sign that it's not truly benefiting them. If it's really helping them, they're going to notice their symptoms reoccur when they're not taking it. And so that's usually my greatest test, is that they will not go without it if it's truly doing something for them. So that's my big test if they forget to take it which many of them do, and even the dog eats their homework sometimes. Something like vitamin D is what I've noticed. And so I say well, then it must not be doing anything for you. Let's just to do what your doctor asked which is to get your vitamin D stores up. But if the dog eats your homework again, well that tells us something about vitamin D and its relationship to your training and performance. So good question for people to ask themselves in an easy way for everyone to gauge what's really benefiting them. Narrator:    Great set everyone; let's cool down. Andrew:     For our cool-down today, here is one of our TriDot athletes with a question for Dr. Austin. Shannon:    Hi, this is Shannon from Bel Air, Maryland. And I'm curious to ask Dr. Austin about dried fruits. I've been on kind of a smoothie kick for a while, and have really started to dial in my nutrition and start to see the performance results. But then this whole pandemic thing came down, and I started to have trouble finding more and more fresh fruits. Plus I started to find more and more shall we say exotic fruits in dried variants. It's not as easy to find mango sometimes, but dried mangoes are always there. And I've started to dial in the various nutrients that come from these various fruits. But what I wonder is once the fruit is dried, am I losing any of those micronutrients or even macronutrients? I know that as bananas ripen their starch amounts volumes if you will start to change. So is this also the case with some other fruits? And am I doing myself a disservice if I use dried fruits? I'd love to always use fresh as much as possible, but sometimes it's not possible. So Dr. Austin what's the verdict, does drying a fruit change its micronutrient content? Andrew: Dr. Austin, what do you have to say to Shannon? Dr. Austin: Well, the difference between dried fruit and real fruit is that oftentimes the dried fruit is a shrunken version of the real one, and you have a higher density of energy intake. And even some of the nutrients are far more dense in a piece of dried fruit. However, you can get certain nutrients like vitamin C that can be really volatile due to the way that they create dried fruit like the heating process. And so you might lose a nutrient like vitamin C in that process. But overall, typically you will get a good bit more of the vitamins, minerals that is in them. So take like a cup of raisins versus a cup of grapes, cup of raisins is going to give you a far better amount of fiber, potassium and copper than a cup of grapes. So really we have to take a step back, and really understand the fruit that you're looking at. Same thing with dried apricots are usually a better source of certain nutrients than fresh apricots including like vitamin A, B, iron and potassium. So a lot of information is out there with regards to the different fruits. And so I would just investigate each of the ones you love, and say am I missing out on anything by taking dried fruit over fresh fruit. Andrew: Is there any particular resource you would point people towards that's reliable when they're doing that research on the fruits they like? Dr. Austin: You know what, I actually would have them tap-in, I would have them tap into chronometer. I would also tell them just to google it online; you can find a lot of great information online about the different dried versus fresh fruit. But off the top of my head, I would tell you it's kind of a googling process if you want to go through it and take a look outside of a tool that actually analyzes food for you. Andrew: I've seen some people suggest that dried fruit can contain more sugar, added sugar compared to fresh fruit. Is that a concern at all of yours with dried fruit? Dr. Austin:  It is, and it isn't. If we use dried fruit the right way at the right times, I think the sugar content that is in it because it will typically be higher in sugar can be a benefit. You also want to really evaluate the dried fruit that you're buying, and making sure that it just hasn't had sugar add it to it. So if you take a look at what you're buying, make sure it's just dried fruit without anything being added to it. You should be okay you'd be getting what you typically would from fruit anyway, it's just condensed. The calories are higher in a cup of raisins versus grape, just because they're condensed, right? So just be cognizant of those couple factors, and I think you'll be okay. Andrew:  Elizabeth, I know you are a big proponent on staying top of the healthy food and a well-rounded diet. Does dried fruit ever make its way into meals in the James household? Elizabeth:  Yes, it does. I like to use dried fruit quite a bit, specifically dried cranberries, adding those to my salads. And a great go-to snack for me is some dried fruit and some nuts. So it is a staple in the James household as well. Andrew: I really like dried pineapple. For me I buy it occasionally, we don't have it often; it's not ongoing in my diet. But every now and then just is a little sweet treat, if I have some dried pineapple in the house of a just a couple pieces almost as like a dessert at lunchtime, but I've never tried to in a smoothie or anything. Dr. Austin used dried fruit in anything in your day to day eating? Dr. Austin: Really rare. If it's around I'll nibble on it, but on the whole Dr. Austin has to stick to the real fruit, because of how her diet is structured. I don't quite have the caloric expenditure that everyone else does, so I got to be pretty mindful. Andrew: Well, that's it for today, folks. A big thanks to Dr. Krista Austin and Coach Elizabeth James for talking with us about supplements. Shout out to Garmin for partnering with us on today's episode, head to garmin.com to find out what Tri-tech should be your next purchase. Enjoying the podcast, have any questions you want to hear our coaches answer? Head to https://TriDot.com/podcasts/ and click on submit feedback to let us know what you're thinking. We'll do it again soon, until then happy training. Outro: Thanks for joining us. Make sure to subscribe and share the TriDot podcast with your triathlon crew. For more great tri content and community, connect with us on Facebook, YouTube, and Instagram. Ready to optimize your training? Head to TriDot.com, and start your free trial today. TriDot, the obvious and automatic choice for triathlon training.  
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